An endoscope is a device which basically comprises an insertion tube, being normally inserted inside the gastrointestinal, respiratory and urinary tract, among others, allowing doctors to verify in loco possible endolumenal alterations.
Apart from being extremely effective to enable endolumenal examination and the diagnosis of diseases, endoscopes have been increasingly used for endoscopic surgeries. The many endoscopic surgeries that may be held include the treatment of certain esophageal diverticula, certain benign tumors and the initial tumors in the esophagus, stomach, duodenum and large intestine, gastric and esophageal varices, bleeding ulcers, removal of bile duct calculi and treatment of chronic pancreatitis, among others.
Due to the absence of incisions in the skin and openings, the technique known as NOTES (Natural Orifice Translumenal Endoscopic Surgery) may be used in endoscopic surgeries (endosurgeries), once it enables, among other advantages, a faster and less painful postoperative recovery, apart from the lack of infections once there are no incisions. However, to make the technique called NOTES possible, the endoscope must have a set of constructive and operational features which enable it as an operation platform for surgical tools.
U.S. Pat. No. 5,797,835 describes a surgical device for use in endoscopy and endosurgery comprising a set formed by two endoscopic devices externally interconnected and inserted in a given part of the body of the patient to be operated in two different points of entry. However, this kind of device is used for application through external incisions in the patient's body, leaving scars and requiring the application of stronger anesthesia, raising the risks of the procedure.
U.S. Pat. No. 6,569,085 discloses a method and a device to provide an endosurgical tool arranged on the exterior of an endoscope for positioning through an unnatural open orifice, implemented by incision, in the body of a patient. This equipment allows tools to be inserted and positioned over the exterior of the endoscope, when this is positioned within the patient's body. Particularly, the patent seeks to solve the problem of how to insert the tools when they have a very large diameter for insertion through the working channel of the endoscope.
However, this type of endoscope has intrinsic limitations, once it facilitates, or at least it does not reduce, the chances of injuries in the patient's organs and the occurrence of infections.
U.S. Pat. No. 6,458,074 discloses a surgical endoscope comprised by two oblong working channels, one of them being vertical and the other one, horizontal. The channels have mechanisms or supports that allow the tools arranged inside them to perform vertical movements, in the vertical oblong working channel, and horizontal movements, in the horizontal oblong working channel. According to the patent, this endoscope makes it possible to reach a broader working area, once the tools move without displacing the tip of the endoscope.
Furthermore, the constitution of the tip of the endoscope limits a lot the size of the medical tools to be manipulated, making it impossible to use the equipment when it is necessary to employ very sharp tools or tweezers with high seizing capacity.
Document WO 2008/070556 describes a conductive tube comprised by an endoscope (fixed platform) and by tubes that conduct its accessories (light guide, objectives, air/water channel), assembled on a platform where several surgeons concomitantly handle the tube and the accessories. It is a very complex device, which works, in fact, as a plurality of physically and operatively associated endoscopes, requiring the presence of several surgeons to operate it, which, in practice, ends up making its use difficult. Furthermore, in comparison with the endoscope of the present invention, this complex device only allows exchanging the tools by removing them through the proximal region of the tube, in other words, the one located outside the patient's body and close to the surgeons who operate him.
In short, it is possible to state that the state of the art related to endoscopic devices used in internal surgeries comprises only combined devices for endoscopic/laparoscopic use, devices which have only two working channels and devices installed externally to the body of an endoscope.
Furthermore, the endoscopes of the state of the art do not allow exchanging the surgical tools through the distal part.
Thus, for the performance of surgeries through translumenal orifices it was develop a unique endoscope which allowed the tools arranged on the working channels to move independently, and which also allowed exchanging the surgical tools through the distal end of the endoscope, expanding the range and the dimensions of the tools to be used.
Embodiments of the present invention aim at providing a surgical endoscope for the performance of surgeries through translumenal orifices (NOTES), which allows carrying out surgeries by means of a single device, without the need of making additional orifices in the patient's body.
Embodiments of the present invention also aim at providing a surgical endoscope for the performance of surgeries through translumenal orifices (NOTES), which allows each surgical tool arranged on each one of the working channels to move freely and independently, expanding their operative capacity.
Embodiments of the present invention further aim at providing a surgical endoscope which allows exchanging surgical tools easily and with a great interchangeability capacity.
Another exemplary purpose of the present invention is to provide a quick, simple and safe process for replacing the surgical tools of the endoscopes, from its distal end.